Clinical Research
Differences of efficacy and the incidence of DCI between early and delayed interventional therapy in patients with intracranial ruptured aneurysms
Chuanyu Li, Haineng Huang, Huadong Huang, Huangde Fu, Qisheng Luo, Kunxiang Luo, Chengjian Qin, Xueyu Li, Chuanhua Zheng, Chuanliu Lan, Xiangui He, Xiangyu Wang
Published 2019-02-15
Cite as Chin J Brain Dis Rehab (Electronic Edition), 2019, 09(1): 30-35. DOI: 10.3877/cma.j.issn.2095-123X.2019.01.007
Abstract
ObjectiveTo investigate the differences of efficacy and the incidence of delayed cerebral ischemia (DCI) between early and delayed interventional therapy in patients with intracranial ruptured aneurysms, and the risk factors leading to postoperative DCI.
MethodsThe clinical data of 98 patients with intracranial ruptured aneurysm who underwent interventional therapy in our hospital from January 2014 to February 2018 were retrospectively analyzed. The patients were divided into early group (n=57) and delayed group (n=41) according to the timing of interventional surgery. All of the patients underwent interventional therapy based on conventional therapy. The early intervention time was within 72 h after the onset, while the delayed intervention time was more than 72 h after the onset. The differences in treatment outcomes, postoperative complications, and prognosis between the two groups were compared, and the multivariate logistic analyses were performed on the risk factors for postoperative DCI.
ResultsThere was no significant difference in the NIHSS scores between the two groups at 7 d after treatment (6.27±2.19 vs 5.76±1.94, P>0.05). The complete embolization rate was significantly higher in the early group than in the delayed group (91.23% vs 73.17%, P<0.05). There was no significant difference in the incidence of postoperative DCI, CVS, rupture in hemorrhage, cerebral edema and lower extremity venous thrombosis between the two groups (P>0.05). The prognosis rate and Barthel index score were significantly higher in the early group at 3 months than in the delayed group (80.70% vs 70.73%, 63.51±13.42 vs 52.78±12.65, P<0.05). The incidence of DCI after treatment in this study was 12.44%. Hypoproteinemia, Fisher grade (Ⅲ-Ⅳ), and WFNS grade (Ⅲ-Ⅴ) were independent risk factors for DCI (OR=4.29, 5.48, 8.074, all P<0.05).
ConclusionInterventional therapy is relatively effective in the treatment of patients with intracranial ruptured aneurysms, but early intervention can improve the embolization effect and improve the prognosis of patients, but the effect of postoperative DCI is not significant, leading to postoperative DCI. Hypoproteinemia, Fisher classification (Ⅲ-Ⅳ) and WFNS grade (Ⅲ-Ⅴ) are independent risk factors.
Key words:
Intracranial aneurysm; Interventional therapy; Timing of treatment; Delayed cerebral ischemia
Contributor Information
Chuanyu Li
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Haineng Huang
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Huadong Huang
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Huangde Fu
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Qisheng Luo
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Kunxiang Luo
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Chengjian Qin
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Xueyu Li
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Chuanhua Zheng
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Chuanliu Lan
Department of Neurosurgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
Xiangui He
Department of Neurosurgery, Guizhou Wangmo County People’s Hospital, Wangmo County 552300, Guizhou Province, China
Xiangyu Wang
Department of Neurosurgery, The First Affiliated Hospital of Ji’nan University, Guangzhou 510000, China
